PART I 1 Name 2 Middle Name 3 Last Name Father's Name 4 PAN No.

5 Date of Birth 6 Flat/Door/Block No 7 Name of Premises/Building/Village 8 Road/Street/Post Office 9 Area of Locality 10 Town/City/District 11 State 12 eMail ID 13 Phone Number with STD Code 14 Pin Code 15 Enter your Bank a/c Number 16 Incase of direct deposite to your bank a/c MICR Code 17 Type of account PART II 1 Income Chargeable under Head 'Salaries' 2 Income Chargeable under Head 'Other Sources' (a) Family Pension (b) Interest (c) Total (a+b) 3 Gross Total Income (1+2c) 4 Deduction under Chapter VI A(Section) (a) 80C (b) 80CCC (c) 80CCD (d) 80D (e) 80DD (f) 80DDB (g) 80E (h) 80G (j) 80GG (k) 80GGA (l) 80GGC (m) 80U (n) Deductions (Total of a to m) 5 Total Income (3-4) 6 Net Agricultural Income 7 Aggregate income (5+6) 8 (a) Tax Payable of aggregate income 121055 THOMAS ANTONY MALIAKKAL ITTICHAN ANTONY ACXPA3323P 19/01/75 ENGINE ROOM INS BHAVNAGAR SBS ROAD FORT MUMBAI MAHARASHTRA

400023

Saving

0 121055 30000

240

30240 90820 0 90820 0

(b) Rebate in respect of Net agri income 9 (a) Tax payable on total income (8a-8b) (b) Surcharge on (9a) (c) Education Cess on (9a+9b) (d) Total Tax Surcharge & Edu cess (9a to 9c) 10 Relief under Section 89 11 Relief under Section 90/91 12 Balance Tax Payable (9d-10-11) 13 (a) Interest payable u/s 234A (b) 234B (c) 234C (d) Total Interest Payable (13a to 13c) 14 Total tax & interest Payable (12+13d) 15 Taxes Paid (a) Advance Tax (b) TDS (c) Self Assessment Tax (d) Total Taxes Paid (15a to 15c) 16 Tax Payable (14-15d) 17 Refund (15d-14) 18 Enter your bank account number 19 Do you want your refund by (cheque or deposited directly into your bank account 20 Incase of Direct Deposit to your bank account give (a) MICR Code of the bank (b) Type of account (saving or current) 21 Date of Submission

0 0 0 0 0 0

0 0 0 0 0 0 0 0

Saving 01/07/2008

HAN ANTONY

AGRICULTRAL INCOME CALCULATION STEP 1 (a) Total income after substracting VI A (b) Agricultural Income © Tax on c

90820 0 90820 0

STEP 2 Agricultural Income Threshold 0 0 0 0 0

© STEP 3

Tax on c

Total Income Total Tax on Income Total Tax to be calculated Edn Cess 3%

90820 0 0 0 0

Government of India

INCOME TAX DEPARTMENT ACKNOWLEDGEMENT
Received with thanks from THOMAS ANTONY a return of income and/or return of fringe benefits in Form No. ITR - 1 for assessment year 2008-09, having the following particulars. Name Middle Name THOMAS Flat/Door/Block No. ENGINE ROOM Road/Street/Post Office SBS ROAD Town/City/District MUMBAI 1 Gross total income 2 Deduction under Chapter - VI-A 3 Total Income 4 Net tax payable 5 Interest payable 6 Total tax and interest payable 7 Taxes Paid a Advance Tax b TDS c TCS d Self Assessment Tax e Total Taxes Paid (7a+7b+7c+7d) 8 Tax Payable (6 - 7d) 9 Refund (7e - 6) 10 Value of Fringe Benefits 11 Total Fringe benefit tax liability 12 Total interest payable 13 Total tax and interest payable 14 Taxes Paid a Advance Tax b Self Assessment Tax c Total Taxes Paid (14a + 14b) 15 Tax Payable (13 - 14c) 16 Refund (14c - 13) Last Name ANTONY PAN ACXPA3323P Name of Premises/Building/Village INS BHAVNAGAR Area/Locality FORT State MAHARASHTRA 1 2 3 4 5 6 7a 7b 7c 7d 7e 8 9 10 11 12 13 14a 14b 14c 15 16 0 0 0 0 0 0 0 0 121055 30240 90815 0 0 0

Receipt No. : Date :

COMPUTATION OF FRINGE COMPUTATION OF INCOME AND TAX BENEFITS AND TAX THEREON THEREON

PERSONAL INFORMATION

Seal and Signature of receiving official

FORM

ITR-1

(For Individuals having Income from Salary / Pension / family pension & Interest) (Please see Rule 12 of the Income -tax Rules, 1962) (Also see attached instructions)

INDIAN INCOME TAX RETURN

Assessment Year 2008-09
PAN ACXPA3323P Dt of Birth(DD/MM/YY) 19/01/75
Employer Category(Tick)

SBS ROAD FORT PSU Others Govt Town / City / District State Pin Code Sex (Tick) MUMBAI MAHARASHTRA 400023 Female Male EMail Address 0 (STD Code) - Phone Number 0 Designation of Assessing Officer (Ward / Circle) Return filed under Section 11 ITOWARD 27(2) {Please see instruction number - 9(i)} Whether original or Revised return ? (Tick) Original Revised If revised, enter Receipt No. and Date of filing original receipt No date return (DD / MM / YYYY) Residential Status(Tick) Resident Non-Resident Resident but Not Ordinarily Resident 1 Income chargeable under the Head 'Salaries" (Salary / Pension) 1 121055 2 Income chargeable under the Head 'Other Sources" a Family Pension 2a 0 b Interest 2b 0 c Total (2a+2b) 0 2c 0 3 Gross Total Income (1+2c) 3 121055 4 Deduction under chapter VI A (section) a 80C 30000 e 80DD 0 i 80GG 0 b 80CCC 0 f 80DDB 0 j 80GGA 0 c 80CCD 0 g 80E 0 k 80GGC 0 d 80D 0 f 80G 240 l 80U 0 m Deductions (Total of a to l) 4m 30240 5 Total Income (3-4m) 5 90815 6 Net Agricultural Income 9 Enter only if greater than Rs. 5,000/-) 6 0 7 Aggregate Income' (5+6) 7 90815 8 a Tax Payable on 'Aggregate Income' 8a 0 b Rebate in respect of Net Agricultural income 8b 0 9 a Tax Payable on Total Income (8a-8b) 9a 0 b Surcharge on 9a 9b 0 c Education Cess on (9a+9b) 9c 0 d Total Tax, Surcharge and Education Cess Payable (9a+9b+9c) 9d 0 10 Relief under Section 89 10 0 11 Relief under Section 90/91 11 0 12 Balance Tax Payable (9d - 10 - 11) 12 0 Do not write or stamp in this area (Space for bar code) 13 a Interest Payable U/s 234A 13a 0 b Interest Payable U/s 234B 13b 0 c Intrest Payable U/s 234C 13c 0 d Total Interest Payable 13d (13a + 13 b + 13c) 0 14 Total Tax and Interest Payable (12+13d) 14 0 For Office Use Only Seal & Signature of receiving Official
TAX COMPUTATION INCOME AND DEDUCTIONS FILING STATUS

PERSONAL INFORMATION

First Name Middle Name THOMAS 0 Flat / Door / Block No. Name of Premises / Building / Village ENGINE ROOM INS BHAVNAGAR Road / Street / Post OfficeArea / Locality

Last Name ANTONY

Receipt No. Date

15 Taxes Paid a Advance Tax (from item 23) 15a 0 b TDS (column 7 of item 21 + column of item 22) 15b 0 c Self Assessment Tax (from item 23) 15c 0 d Total Taxes Paid (15a+15b+15c) 15d 0 16 Tax Payable (14-15d) (Enter if 14 is greater than 15d, else leave blank) 16 0 17 Refund (15d-14)(Enter if 15d is greater than 14, also give Bank Account details below) 17 0 18 Enter your bank account number (mandatory in case of refund) 0 Cheque or deposited directly into your bank account (tick as applicable) 19 Do you want your refund by 20 In case of direct deposit to your bank account give additional details MICR Code 0 Type of Account Saving Current
Sl. No.
Tax Deduction Account Name & Address of the Employer Number (TAN) of the Employer Income Deduction under Tax Payable (incl Chargeable Chapter VI-A surch & edn cess) under the head Salaries Total tax deposited Tax Payable/refund able

TDS ON SALARY

REFUND

TAXES PAID

21 Details of Tax Deducted at Source from Salary [As per From 16 issued by Employer(s)]

(1)

(2)

(3)
Inte HQ, MoD(Navy), (GOI), New Delhi 110 011, Naval Pay Office, SBS Rd, Mumbai - 400 023

(4) 121055

(5) 30240

(6) 0

(7) 0

(8) 0

(i) MUMN12612F (ii)

TDS ON INTEREST

22 Details of Tax Deducted at Source on Interest [As per From 16 issued by Deductor(s)] Name & Address of the Deductor Amount paid/ Date of Total Tax Tax Deduction Sl credited Payment / deposited No. Account Number Credit (TAN) of the (1) (i) (ii) (iii) NOTE : Enter the total of column (7) of 21 and column (7) of 22 in Sl No. 15b of TAXES PAID
Deductor

Amount out of (6) claimed for this year

(2)

(3)

(4)

(5)

(6)

(7)

23 Details of Advance Tax and Self Assessment Tax Payments Sl.N Name of Bank & BSR Code Date of Deposit o. Branch

Serial Number of Challan Amount

i ii iii iv v NOTE : Enter the totals of Advance tax and self Assessment tax in Sl. No. 15a and 15c of TAXES PAID 24 Other Information (transactions reported through Annual Information Return) (Please see instruction number -9(ii) for code) Sl Code Amount (Rs) Sl. Code Sl. Code Amount (Rs) a 001 d 004 g 007 b 002 e 005 h 008 c 003 f 006 25 Tax-exempt interest income (for reporting purposes only) 26 E-filing Acknowledgment Number VERIFICATION 25
Date (dd/mm/yy) Amount (Rs)

I, THOMAS 0 ANTONY son/daughter of MALIAKKAL ITTICHAN ANTONY solemnly declare that to the best of my knowledge and belief, the information given in the return thereto is correct & complete & that the amount of total income & other particulars shown therein are truly stated and are in accordance with the provisions of the Income tax Act 1961, in respect of income chargeaable to Income tax for the previous to the Assessment year relevant year 2007-08.

Place

Mumbai

Date

39630

Sign here

27 If the return has been prepared by a Tax Return Preparer (TRP) give further details as below Identification No. of TRP Name of TRP Counter Signature of TRP
If TRP is entitled for any reimbursement from the Government, amount thereof (to be filled by TRP)
Prepared & Compiled by : Manoj Mugale POWTR & Kishor Deokar POWTR

28